eyes on the U.S.
David L. Scheiner*
September 12, 2016
Hillary Clinton nearly collapsed after being forced to leave a 9/11 commemoration early on Sunday. Her campaign later released a statement that she had been diagnosed last week with pneumonia. The following article was originally published Friday.
Eight years ago, I wrote a medical report on the health of then-presidential candidate Barack Obama, whose personal physician I had been for 22 years. That report was 276 words and described Obama's health as excellent. I was derided for issuing such a brief report, but there was nothing of significance in the medical history of this healthy, 47-year-old male. Meanwhile, Republican John McCain â€" a 71-year-old with a history of skin cancer â€" made nearly 1,200 pages of records available for a group of reporters to review.
Today, the two major candidates for president are each almost as old as McCain was in 2008. Having been in practice for 50 years serving a predominantly geriatric patient population, and now a septuagenarian myself, I can attest that the American people need much more medical information from these candidates. If elected, 70-year-old Donald Trump would be the oldest person ever to enter the Oval Office, while Hillary Clinton, 68, would be a close second, behind Ronald Reagan. At these ages, stuff begins to happen.
What do we know about Clinton? Importantly, she deserves credit for issuing a useful two-page letter from her doctor in July 2015, but unfortunately that document raised as many questions as it answered.
We were told that Clinton has an underactive thyroid that is being treated with a replacement hormone and that she has a history of suffering thrombophlebitis (venous blood clots) in her legs. This leads me to wonder if these clots were provoked by trauma or some other cause, since unprovoked clots have a more worrisome prognosis. Around the time of her 2012 fall and concussion, Clinton suffered a venous thrombosis in her brain, and she is now on a blood thinner called Coumadin. This is a difficult drug to control, and close monitoring of prothrombin times â€" a measure of how long it takes a person's blood to clot â€" is necessary. We physicians should see a record of her prothrombin times to assess adequacy of control. Being on Coumadin, she would have to avoid certain foods, such as green leafy vegetables, and avoid medications with problematic interactions. There are new anticoagulant medications that don't require such monitoring or diet and drug restrictions. Why isn't she on this more efficacious medication?
It took Clinton up to six months to make a full recovery, and for two months, she had double vision. This was not a simple concussion. In 2013, her doctor's letter reported, her neurologic exam was normal. But that was three years ago. Concussions can cause cognitive decline. Would a current neuro-psychologic exam show any change?
This is all somewhat unfair to Clinton, however, who ends up being placed under greater scrutiny as a consequence of acting more responsibly than her opponent. We can ask specific questions about her health because she has been willing to share some important information, even if it is inadequate. In contrast, we know nothing about Trump's health.
A one-page letter from his doctor â€" a gastroenterologist, not the type of physician who usually provides primary care â€" reported that Trump's "strength and stamina" were "extraordinary." We were told "unequivocally" that he would be "the healthiest individual ever elected to the presidency." This stunningly unprofessional, hastily written letter contained only minimal medical information.
We essentially have no medical information on Trump. It's impossible to know what questions to ask. We're told he has had "no significant medical problems." We are told that Trump plays golf regularly. We are told that his "cardiovascular status is excellent." I would very much like to see documentation of all this. In particular, in view of his somewhat erratic behavior during the campaign, I believe Trump also should undergo a neuro-psychologic evaluation; if normal, this would at least put an end to speculation that he has a personality disorder. He is a septuagenarian asking voters to place him in one of the most demanding jobs on earth. We need to see his medical records.
Throughout this country's history, from Woodrow Wilson's stroke to Franklin D. Roosevelt's polio to John F. Kennedy's Addison's disease, Americans have repeatedly not been given important medical information about their leaders. It's no wonder they are asking so many questions this year, but speculation and unanswered questions don't serve anyone very well - not the voters, not the candidates. McCain set the standard. The medical reports from Clinton's and Trump's personal physicians do not suffice.
*David L. Scheiner is an assistant professor at the University of Illinois Medical School.
THE WASHINGTON POST
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Once meant to protect the royal family, the century-old law has become a tool for the military-led government in Bangkok to stamp out all dissent. A new report outlines the abuses.
Laura Valentina Cortés Sierra
October 22, 2021
"We need to reform the institution of the monarchy in Thailand. It is the root of the problem." Those words, from Thai student activist Juthatip Sirikan, are a clear expression of the growing youth-led movement that is challenging the legitimacy of the government and demanding deep political changes in the Southeast Asian nation. Yet those very same words could also send Sirikan to jail.
Thailand's Criminal Code 'Lèse-Majesté' Article 112 imposes jail terms for defaming, insulting, or threatening the monarchy, with sentences of three to 15 years. This law has been present in Thai politics since 1908, though applied sparingly, only when direct verbal or written attacks against members of the royal family.
But after the May 2014 military coup d'état, Thailand experienced the first wave of lèse-majesté arrests, prosecutions, and detentions of at least 127 individuals arrested in a much wider interpretation of the law.
The recent report 'Second Wave: The Return of Lèse-Majesté in Thailand', documents how the Thai government has "used and abused Article 112 of the Criminal Code to target pro-democracy activists and protesters in relation to their online political expression and participation in peaceful pro-democracy demonstrations."
Criticism of any 'royal project'
The investigation shows 124 individuals, including at least eight minors, have been charged with lèse-majesté between November 2020 and August 2021. Nineteen of them served jail time. The new wave of charges is cited as a response to the rising pro-democracy protests across Thailand over the past year.
Juthatip Sirikan explains that the law is now being applied in such a broad way that people are not allowed to question government budgets and expenditure if they have any relationship with the royal family, which stifles criticism of the most basic government decision-making since there are an estimated 5,000 ongoing "royal" projects. "Article 112 of lèse-majesté could be the key (factor) in Thailand's political problems" the young activist argues.
In 2020 the Move Forward opposition party questioned royal spending paid by government departments, including nearly 3 billion baht (89,874,174 USD) from the Defense Ministry and Thai police for royal security, and 7 billion baht budgeted for royal development projects, as well as 38 planes and helicopters for the monarchy. Previously, on June 16, 2018, it was revealed that Thailand's Crown Property Bureau transferred its entire portfolio to the new King Maha Vajiralongkorn.
Protestors In Bangkok Call For Political Prisoner Release
Freedom of speech at stake
"Article 112 shuts down all freedom of speech in this country", says Sirikan. "Even the political parties fear to touch the subject, so it blocks most things. This country cannot move anywhere if we still have this law."
The student activist herself was charged with lèse-majesté in September 2020, after simply citing a list of public documents that refer to royal family expenditure. Sirikan comes from a family that has faced the consequences of decades of political repression. Her grandfather, Tiang Sirikhan was a journalist and politician who openly protested against Thailand's involvement in World War II. He was accused of being a Communist and abducted in 1952. According to Sirikhan's family, he was killed by the state.
The new report was conducted by The International Federation for Human Rights (FIDH), Thai Lawyer for Human Rights (TLHR), and Internet Law Reform Dialogue (iLaw). It accuses Thai authorities of an increasingly broad interpretation of Article 112, to the point of "absurdity," including charges against people for criticizing the government's COVID-19 vaccine management, wearing crop tops, insulting the previous monarch, or quoting a United Nations statement about Article 112.
Juthatip Sirikan speaks in front of democracy monument.
Shift to social media
While in the past the Article was only used against people who spoke about the royals, it's now being used as an alibi for more general political repression — which has also spurred more open campaigning to abolish it. Sirikan recounts recent cases of police charging people for spreading paint near the picture of the king during a protest, or even just for having a picture of the king as phone wallpaper.
The more than a century-old law is now largely playing out online, where much of today's protest takes place in Thailand. Sirikan says people are willing to go further on social media to expose information such as how the king intervenes in politics and the monarchy's accumulation of wealth, information the mainstream media rarely reports on them.
Not surprisingly, however, social media is heavily monitored and the military is involved in Intelligence operations and cyber attacks against human rights defenders and critics of any kind. In October 2020, Twitter took down 926 accounts, linked to the army and the government, which promoted themselves and attacked political opposition, and this June, Google removed two Maps with pictures, names, and addresses, of more than 400 people who were accused of insulting the Thai monarchy. "They are trying to control the internet as well," Sirikan says. "They are trying to censor every content that they find a threat".
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